| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 104 === The purposes of this study were twofold: (1) to explore trends of pain, anxiety, and acute confusion at pre-operative period (T1), 24 hours within post-operation (T2), and 72 hours after post-operation; and (2) to discover predictors of acute confusion in patients with abdominal surgery over the pre-post operation period.
A prospective, observational, repeated-measure, correlational design was adopted. Patients with abdominal surgery who admitted to intensive care unit were recruited from a medical center in the northern Taiwan. Inclusion criteria were patients aged twenty and above, and with a Richmond Agitation Sedation Scale score between -3 and +4.
Results of this study were as followings. The overall incidence of acute confusion was 16.7%; and the highest incidence was 10% at T2. Using generalized estimating equation analysis, results showed that the change of pain and acute confusion were significantly different over the three time points. The highest pain score was at T2, and then it decreased at T3. The incidence of acute confusion also increased as time passed by. The change in anxiety through the pre-post operation was not significantly different. The different domains of heart rate variation were all with downward trends at T2, and then followed upward curves at T3. The predictors of acute confusion were pain, anxiety (high- and low frequency hear rate variation), age, status of consciousness, level of liver enzyme, and number of complications.
Results of this study help to understand the change of pain, anxiety, and acute confusion over the pre-post operation period in patients with abdominal surgery. Recommendations from this study results are (1) to incorporate the acute confusion assessment with the routine nursing care, and (2) to monitor predictors of acute confusion in patients with abdominal surgery during their pre-post operation period.
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